Understanding reasons for image rejection by radiologists and radiographers

Area of Science:

• Radiology
• Medical Imaging
• Radiography

Background:

• Radiographers determine radiograph acceptability for diagnosis, influencing repeat examinations.
• Disagreements exist between radiographers and radiologists regarding diagnostic image value.
• This study explores image quality parameters as potential explanations for interprofessional differences.

Purpose of the Study:

• To investigate if image quality parameters explain the differing diagnostic value assessments between radiographers and radiologists.
• To compare radiographer and radiologist evaluations of radiograph quality and diagnostic sufficiency.

Main Methods:

• 74 radiographers and radiologists from three countries assessed 75 radiographs (chest PA, hip HBL, c-spine lateral).
• Observers scored image quality (anatomical visualization, positioning, collimation, detector exposure) and diagnostic value (ACR RadLex).
• Visual grading characteristics compared intergroup evaluations.

Main Results:

• Radiographers rated anatomical visualization lower than radiologists, though not significantly.
• Radiographers rejected more radiographs based on RadLex categories.
• Subjective detector exposure assessment correlated with RadLex ratings; no differences in positioning or collimation evaluations were found between groups.

Conclusions:

• Agreement exists on anatomical visualization, but radiographers are more critical of diagnostic value.
• Anatomical visualization does not explain the observed professional differences.
• Inappropriate detector exposure assessment strongly correlates with radiograph rejection, especially for radiographers.